I don't make this stuff up!…but I do change identifying information.

Today I had a patient who recently underwent a hemorrhoidectomy/rectal prolapse repair. His doctor is a well-known anorectal surgeon. I saw the patient for a health care maintenance visit and he reported that he was doing well. During my routine health care review, I asked him if he had any current sexual partners. My patient, who is gay, replied “No. I don’t want to date anyone right now. And even if I did, I don’t know how I would have sex with them. Cause of the surgery, you know.” I asked him if the surgeon had given him any post-operative instructions on how long to avoid anal sex. Weeks? Months? For the rest of his life? The patient said he didn’t know. The only instructions the surgeon had given him? “He told me to ‘behave myself’.” What does that mean? I said that out loud, and the patient agreed that he didn’t know. He had been too embarrassed to ask the surgeon to elaborate any further. You would think that an anorectal surgeon–a man who looks at, talks about and deals with ass all day long–would be able to give the patient a little more detail about his postoperative care. Could the surgeon not bring himself to say the words ‘anal sex’? Seriously? What an asshole. Hahahahaha.

Me: “Well, I remember you mentioned it last time but you didn’t want to talk about it. Can you tell me more about it now?”

Patient: “I have erections that last for hours. Like 3 hours, or more. It’s terrible.”

Me, beginning to scribble down “priapism” on my notes: “And then what happens? Do they go down on their own after that?”

Patient: “No. I have to…you know, take care of things myself. And it hurts! It’s awful. But I’m lonely, you know I don’t have a girlfriend. So I have to do it myself.”

Me, crossing out “priapism”: “So when you ejaculate, the erection goes away?”

Patient: “Yes! But it hurts!”

Me: “Maybe it would hurt less if you didn’t wait so long.”

Patient (who I think has Body Dysmorphic Disorder, among other issues): “I can’t be around women. I can’t even hire a hooker, because my face is so horribly deformed. Even a hooker wouldn’t want to look at me.”

Me: “I’m sorry you feel that way. That’s terrible. But if you ever do decide to hire a hooker, please use a condom every time. It’s very important.”

I’m always behind on my progress notes. Sometimes not TOO behind (like..a couple of days). Sometimes a week behind. I know, I know…it’s not optimal. Now that I’m approaching the final weeks of pregnancy (I’m almost to term, yikes!) I am having daily panic about how I’m going to catch up with it all before the big day arrives. I’m sure the answer is not to spend a lot of time writing blog entries, so I’ll have to go back to my notes now. Sigh.

This afternoon I was hungry. Like, ravenously, 3rd-trimester-of-pregnancy hungry. The protein bar I had packed in my lunch bag seemed boring and unappealing. I decided I would get a snack from the office vending machine. The last time I bought something from the machine, they had fruit snacks (you know, those squishy fruit-shaped jelly things). Fruit snacks aren’t the healthiest snack ever, but they’re not SO bad. Unfortunately, the fruit snacks were gone. I stood in front of the vending machine debating the choices: Sun Chips? Granola bar? Fiber bar? Potato chips? You know what I chose? A Moon Pie! A Moon Pie. Possibly the least healthy option in the entire vending machine. It just looked so…delicious. The sad part about this choice is that I know that a Moon Pie is like eating a piece of crap coated with fake chocolate. I’m a pregnant healthcare provider, for god’s sake! If anyone should be making a nutritious food choice, it should be me. Yet I felt powerless to make a healthier choice. It’s a good reminder that education doesn’t always equal the right choices. Sigh.